Some grief misconceptions

My 15 year old cousin Marie died in a car accident in 1977 and my aunt, now 92 continues to grieve her every single day. I remain impressed that she gets out of bed, has a lively sense of humor, and continue to love life. 

About five years after Marie’s death my aunt was going to the cemetery and she paused to say hello to her neighbor. The neighbor asked, “How are you?”

My aunt replied: “Not good at all. Today is Marie’s birthday.”

The neighbor: “Aren’t you over that yet? How long has it been?”

I’m not quite sure what my aunt said. She is a polite woman who was probably too shocked and in pain to say anything. 

My aunt’s other ‘favorite’ was: “God only gives you as much as you can handle.”  Her succinct reply is: “He’s wrong, I can’t handle this.” 

I think one of the biggest misconceptions about grief is that it ends; that you should work towards closure, moving on, or getting over it. That rarely happens.

When someone who you love or care about dies you’re given a weight. In the beginning that weight feels so heavy. You drop it a lot, stumble over it, sometimes you need others to help you carry it. As time goes by, you develop grief muscles. It gets easier to carry but it never goes away. 

There are a lot of grief theories out there. There are stages (originally based on the stages of dying but reworked for grief), there are tasks, there are processes. There are theories about complicated grief, traumatic grief and distorted grief (and that’s not the entire list). 

And in the end, it seems that what is an elemental and ubiquitous human experience is almost impossible to generalize. What worked for my aunt might not work for someone else. It might help someone to hear that God only gives them as much as they can handle. It might help them dig into their faith more and use it to help them get through the grief. 

Another misconception is about denial and some feel that denial is a stage, and it can be. However, denial is better explained as a defense mechanism and it is an understandable one. Most don’t want to believe that their loved one is really gone.  

Denial is elusive and hard to spot. Someone might say “of course I know they are dead” but actually might speak in other ways and exhibit behaviors that illustrate the denial is there and it is making it difficult for them to process their grief. 

You shouldn’t force the abandonment of denial. It is protective sometimes and needs to be managed gently. Of course a parent doesn’t want to say that their child is dead and buried in a cemetery or their ashes are scattered at a lake. They want to pretend they are on a trip, or will be back soon. It’s understandable and needs to be challenged very gently (if at all). 

Like everything in grief, it takes time. 

The year of grief is another misconception. Grief does not have a time table. Some say the second year is actually harder than the first. Others can resolve the most intense phase of grief within a year and feel better after that first anniversary. It all depends on the person, their mental health, ability to regulate their emotions, their support system, the relationship they had with the deceased; I could keep going. 

It just depends. 

Technology & Grief

You might not think that grief and technology would be a good fit but there are many digital options to help those who are grieving. You don’t need complicated equipment (although there are options for those interested in grieving with virtual reality). Facebook, your favorite app store, or the old fashioned internet can find you a place to connect with others in your grief. 

There can be comfort in community and technology can connect you with a general or specific community. If you are the parent of a child who died by suicide, or drug overdose, or brain cancer, you can find a digital group that will consist of others in your situation. That is the beauty of digital spaces; you don’t have to go to be in the same zip code, or even the same time zone. 

Facebook offers easy to join groups and the platform is simple to use if you’re already on the social media site. A search of grief support group reveals pages and pages of support groups available. This is a positive, and a negative. Often, especially in the early days and weeks of grief, trying to figure out anything, even the most mundane tasks takes much more time than it did before. Trying to wade through all of the choices and find the one right for you might take some trial and error. As in all things grief, be gentle to yourself.

Photo by Hammer & Tuck

If you’re not on social media, you can search through your app store for grief apps. There are less apps than Facebook groups, for sure, but there are options that can connect you with local grief groups, or online chat groups. There is the Grief Support Network, Good Grief, Grief Loss among others. 

Another way that many people grieve online, that does not include groups or even other people, is memorial pages on Facebook. After someone dies, their page can be maintained and it enables friends and loved ones to leave messages and connect with others. 

Whatsyourgrief.com is an excellent website that has a well-written blog, Facebook group, online courses, and webinars. The authors tackle a variety of subjects related to grief. They also host a podcast in case you can’t, or don’t want to spend time reading. 

An interesting way to connect with others in online spaces is through virtual reality.In an article in Medical Daily, a person described how moving it was to attend a VR grief group. She told how she was able to cry in the safety of her own home while listening to others share their grief but her avatar did not show any emotion. The literal space between her feelings and the others increased her comfort level and she felt safe enough to cry. This is just one way that virtual reality might be able to help those grieving. 

Virtual reality has been shown to be helpful in exposure therapy and in certain circumstances, grief can include things like exposure to certain places or things that increase feelings of grief. Using VR could improve a person’s coping. 

In the end, grief is a unique experience for each person. Digital spaces might help a person grieve; or they may not. It is just another tool to use when and if you want to. 

Trauma informed grief

              Trauma informed care, with its core principles of safety, choice, collaboration, trustworthiness and empowerment are the cornerstones of any therapeutic relationship or intervention. Grief therapy is no different.

              It is vital for someone who is working through the grief of losing one or many people, from illness, accident, suicide or overdose, to have choice about how and when to grieve. Although research shows that processing grief is a healthy way to manage the loss, it’s not something you can, or should, require from someone.

Photo by Ravi Roshan on Unsplash

              Sometimes people who feel shocked and numb throughout the death, funeral, and for weeks or months after a loss think that means they haven’t grieved.  This can be further complicated if there is a significant amount of drug or alcohol use during this time period. Clients have said: “I never grieved” thinking that the numbness was evidence they weren’t grieving; instead of understanding that it is just part of the process. Your brain, I think, just gives you a bit of a break from the full extent of the loss in the beginning.

              Grief counseling, really every kind of counseling, must have collaboration. The client is the expert of their life, not the counselor. The grief journey can be so painful and clients need to know they are the one driving the bus. The counselor might have the map, but the client is at the wheel for the entire trip. “You could turn here,” we might tell our client. If they say, “no thanks, I’d rather keep going this way” then all we can do is be patient.  Best not to ask: “are we there yet?”

              To continue the bus metaphor, sometimes a client might throw their hands up, tell us to “take the wheel” and “tell me what to do.”  Although it’s so tempting, we know it isn’t the best way to foster empowerment. “You’ve got this.” “It’s hard but you’ve come so far.” “I’m right here next to you.” Maybe the client is anticipating an upcoming holiday. Do they celebrate it exactly as they celebrated it with their loved one? Or do something entirely different; maybe avoid celebrating it altogether?  They need to make that decision for themselves; the therapist can only offer options and explain why some people might chose one or the other. 

              Trust can be so fragile. If you make a mistake own it, apologize and make amends. If there is no trust in a therapeutic relationship there is no therapeutic relationship. It’s that simple. We make mistakes, say we’re going to call and then get overwhelmed and forget, or put it off. It’s okay, we’re human. Perfection is not trustworthiness; we need to model for clients how to make mistakes and repair a relationship.

              If the ingredients of trauma informed care make a soup, then safety is the broth. Without it, you can’t really have soup, it’s just random ingredients tossed together. They might taste good, but it isn’t soup. Safety is an elemental need for all of us. In order to work through the painful thoughts and feelings connected with the death of a family member, or a friend, or even an acquaintance, clients need a safety that cocoons them in support.

Grief is hard. It can hurt in every cell of your body and a trauma informed care approach should be the foundation of any grief work.

Welcome to Resisting Grief

Why is it important to talk about the connection between grief and addiction? Grief can make sobriety harder. And addiction can make grief feel impossible. Researchers have shown that grief after the death of a loved one can increase someone’s risk for addiction, substance or alcohol use, or relapse. 

Photo credit: Mike Labrum

The pain of grief can be immense and people often try to find things that will numb that pain; sometimes that is alcohol or other substances. And if someone is already at risk for addiction, or has a history of alcohol or substance use, avoiding grief can turn into a cycle of use, guilt, and pain. And that makes sobriety, or even reducing use, very difficult.  

I was high at my mother’s funeral. I just never dealt with it.

Grief is both unique and ubiquitous. Everyone will experience it at one point in their life; and everyone’s grief journey is different. Research about grief and how it affects people, spans a century, and researchers and clinicians continue to try to find ways to help people deal with the pain and aftermath of losing a loved one. 

Much of grief research looks at grieving the loss of one person. Those who are touched by addiction experience, especially within the opioid crisis, know many more losses than that. 

They used together but one woke up and the other one didn’t.

The higher number of deaths, closer together, that someone experiences, the more likely that complicated grief, or even traumatic grief, can develop. Add to that months or years of grief distorted by continued use and it’s a recipe for depression, anxiety, guilt and possibly symptoms of posttraumatic stress disorder. 

Over the last 2 years I know 12 people who have died from overdoses.

Grieving takes time. It takes effort and patience in order to develop tolerance to the pain of grief. And recovery takes time. It takes skills and support. Doing both together can be exponentially more difficult. 

Add to that a sense of “nope, I don’t do funerals; I don’t do grief.” If you know that grief can increase someone’s risk of relapse or addiction, it’s important to grieve, right? 

And how exactly do you do that? As a friend or family member or, as a clinician? That’s what this blog is going to be exploring. We’re going to be looking at grief and how it is affected by addiction as well as how addiction is affected by grief — among other things that might make grieving harder. 

  • References:
  • Masferrer, L., Garre-Olmo, J. & Caparrós, B. (2017) Is complicated grief a risk factor for substance use? A comparison of substance-users and normative grievers. Addiction Research & Theory. Vol. 25 No. 5 361-367
  • Mercer, D.L. & Evan, J.M. (2006) The impact of multiple losses on the grieving process: An exploratory study. Journal of Loss and Trauma 11:219-227